DASH prediction score for recurrent VTE
This model was developed to help stratify patients with a first unprovoked VTE according to their risk of disease recurrence and, thereby, identify patients who may benefit from long-term (or stopping of) anticoagulant therapy.

Research authors: Tosetto A, Iorio A, Marcucci M, Baglin T, Cushman M, Eichinger S, Palareti G, Poli D, Tait RC, Douketis J
Details Formula Study characteristics Files & References
★★★
Model author
Model ID
301
Version
1.9
Revision date
2016-04-25
Specialty
MeSH terms
  • Embolism, Pulmonary
  • Recurrence
  • Deep Venous Thrombosis
  • Assessment, Risk
  • Model type
    Linear model (Calculation)
    Status
    public
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    Formula
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    Condition Formula

    Additional information

    This model was elaborated on the basis of data of a patient-level meta-analysisof 1818 patients with unprovoked VTE treated for at least 3 months with a VKA, with 239 recurrent VTE events.

    Inclusion- & exclusion criteria:
    Eligible VTE cases were defined as as those that occurred in the absence of an antecedent major clinical VTE risk factor comprising surgery, trauma, active cancer, immobility, or pregnancy and the puerperium. VTE that occurred in association with hormonal therapy (oral contraceptive or hormone replacement therapy or a thrombophilic blood abnormality and no other VTE risks were also included. Patients with known antiphospholipid antibodies or antithrombin deficiency were excluded because these patients were excluded from the source studies.

    Study Population

    Total population size: 1818
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name LL Q1 Median Q3 UL Unit
    Duration of anticoagulation in recurrent VTE group 6.7 Months
    Duration of anticoagulation in no recurrence group 6.8 Months
    Age in recurrent VTE group 63 Years
    Age in no recurrence group 61 Years
    Body mass index in recurrent VTE group 27.2 kg/m2
    Body mass index in no recurrence group 27.2 kg/m2

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Use of hormones at time of index VTE (females) Recurrent VTE group 46
    No recurrence group 572
    Trombophilia present Recurrent VTE group 56
    No recurrence group 331
    Abnormal D-dimer Recurrent VTE group 162
    No recurrence group 664

    DASH score for recurrent VTE:
    ...
    points

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    Result
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    DASH score for recurrent VTE: points

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    Outcome stratification

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    Conditional information

    Result interpretation

    Patients with a DASH score of 1 or less are considered to be at low risk for recurrence. The model was found to have a satisfactory predictive capability (c-index: 0.71). The authors conclude that a lifelong anticoagulation may be avoided in low-risk patients with unprovoked VTE.

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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